To the Editor: In their randomized trial, Dr Dember and colleagues1 studied the effect of clopidogrel on early failure of arteriovenous fistulas. They concluded that clopidogrel was able to prevent thrombosis but did not lead to a higher incidence of functional fistulas. The authors made the valuable distinction between preventing thrombosis and providing patients with a functional fistula for dialysis. Functional vascular access is a major concern to dialysis patients and their clinicians, especially against the background of low primary patency rate of arteriovenous fistulas.
Wusirika R, Rao P. Effect of Clopidogrel on Arteriovenous Fistulas for Dialysis. JAMA. 2008;300(14):1647-1649. doi:10.1001/jama.300.14.1647-a